Standards

ACA has developed:

• Program Standards and Guidelines for Hospital in the Home
• Chemotherapy Standards for Hospital in the Home

Many hospitals are setting up hospital in the home programs and extending the care that they provide into the patient's home. For many of these hospitals, providing care in the home is a new venture, as is the provision of acute care in the home. Currently, Standards for health care do not address the concept of acute care provision in the community. Therefore, ACA has undertaken the development of Program Standards and Guidelines for Hospital in the Home. It is anticipated that this works will promote best practice, guide hospitals in the development of their HITH programs and enable evaluation of programs.

The Program Standards and Guidelines have been developed in consultation with HITH clinicians from throughout Victoria and were informed by the work already done in the development of Chemotherapy Standards for Hospital in the Home. Following the completion of th eStandards, a pilot process was conducted, at several VictorianHITH programs, to validate the content of the Standards. The content of the Standards incorporates:

1. Continuum of Care
   • Access & Entry
     • Communication - patients and carers
     • Consent
     • Patient referral
   • Assessment
     • Patient selection
   • Care planning
     • Care planning
   • Implementation of Care
     • Communication - health care professionals
     • Death of a patient at home
     • Drug Therapy
     • Medical emergency procedures
     • Patient access to staff
     • Contracting to service providers
   • Separation & Community Management
     • Discharge planning
2. Human Resource Management
   • Staff Competency and ongoing education
3. Information Management
   • Documentation and medical records
4. Risk Management
   • Infection control
   • Risk management
5. Improving Performance
   • Quality improvement

The chemotherapy standards have been developed by a multidisciplinary team that includes representation from medical oncologists, registered nurses delivering chemotherapy in the home setting, hospital pharmacists and ACA staff. As with the Program Standards and Guidelines for HITH, these Standards have undergone a pilot process to ensure their validity.

The scopes of practice encompassed by these standards are:

• Communication - health care professionals
• Communication - patients and carers
• Consent
• Credentialing and ongoing education of staff
• Medical emergency procedures
• Patient access to staff
• Patient referral
• Patient selection
• Pharmacy
• Quality improvement
• Safety management